Posting in the Ask the Docs forum -- Please let the Docs answer the questions. Thanks!

A favor please? The docs are having a hard time sometimes telling which threads in the Ask the Docs forum have or have not been responded to by another doctor because some of us are posting responses there; some of those threads get rather lengthy. I am guilty too.

Let's let the docs be the only ones answering the questions in the Ask the Docs forum, please.

There are no barefoot friendly Doc's in my area (thanks for the map), so I'm hoping someone can give me some advice.

I used to walk fast on the treadmill and wore regular sneakers (i didnt know i was damaging my body) then my general practitioner told me I should get more aerobic exercise so I increased my speed (still walking though). Then suddenly I started having foot pain that didn't go away. My arches felt weak and just wanted to fall to the floor. The pain was in my arches and it got so bad that eventually I was having a hard time walking. I saw two podiatrists. Both told me to use custom orthotics. One said I was developing that bunion thingy where your big toe moves inward and the 1st met moves outward. The other told me I didn't have that.

I wore the custom orthotics, which hurt my feet, but the podiatrist told me I just needed to get adjusted. A year later my left foot which was always worse than the right was still painful and the orthotics didn't seem to be helping at all. The arches still felt very weak and I had developed a new condition that wouldn't go away... Achilles tendonitis. I saw a physical therapist who told me I had a tight ilio-tibial band and gave me stretches that didn't help. Finally about two months ago I got onto some barefoot info online. I stopped using the orthotics, I got some Correct Toes and have been walking barefoot as much as possible. For a while I was doing alright but then I started to get horrible pain in my left foot again. This time the pain was on the bottom of the foot (not in the arch) in the middle, running from the second metatarsal head, along the bottom of the foot toward the heel.

I did more research online and found out about Morton's toe. I seem to have it but I'm not sure it is that bad, or bad enough to warrant wearing a pad under the 1st met head (I also was wondering why my second toe was pointing away from the big toe so much and this seemed to explain it). Still, I thought if I tried the pad under the first metatarsal head and that helped the pain then that would be pretty conclusive. So I've been wearing the pad under the 1st met and the pain pretty much went away immediately when I started doing that but now I'm getting a callous at the met head of my little toe and I'm wondering if I'm really doing the right thing wearing the pad. Was I just getting pain because my arches were so weak? Should I try not wearing the pad? Is there another reason why my second toe points way far away from my big toe?

I should add that my feet have gotten SO much better since walking barefoot! Before I could barely stretch my toes apart or move them around much and now they are really limber and I can stretch them out, but my left foot still gets cramps REALLY easily in the arch. Like if i stretch my big toe out or press it down too much. Is that because it is so weak?

Sorry for the lengthy post, I just thought you should have the details. I hope someone can advise me. Thanks for the great website!

Wow, that is a lengthy post . When I hear an issue like yours, I always want to get back to basics. While the pain is in your foot, the problems are likely in your core. I see this quite a bit because as patients, it is natural to look at where you hurt but unfortunately, as doctors, we are also guilty of looking at where you hurt rather than why. We need to ask ourselves why are the calves tight, arches weak, etc and why did if feel better barefoot while you developed some other issues.

Usually, a torqued core will create this. A week ago, I visited a local running store that I refer back and forth with and he was having problems. He is a pretty strong willed gentleman so I am often surprised when he listens to my suggestions ( he makes like he wont but he surprises me). The other day, he said his back and hips were all messed up and he is a shod runner. A while back he complained of achillies tendon issues and a podiatrist gave him custom orthotics.

Upon evaluation, his core was torqued ( which will cause many of the problems you described in your feet), he had tight it bands, quads, hip flexors and gluts. I did some work on him as a favor on one of the benches in the store and set him up with an off the shelf insert (the custom one's were done poorly and were not helping him, even though he was compliant (sound familiar.) ). I have no idea if he had a mortons toe however I can make some assumptions based on your experiences.

1. You are built asymmetrically.
2. You have tight gluts, your core is distorted (look in the mirror, is one much higher than the other?)
3. Your upper body is tight and you hunch your shoulders when you run.

To understand the reasons behind this, you may wish to read my book Cheating Mother Nature, what you need to know to beat chronic pain which is available through Amazon.com

Things you can do to relieve this.
1. Find a good sports chiropractor (they do not have to necessarily be barefoot friendly, they just need to understand body mechanics)
2. Use a foam roller, check out our video on how to use this for runners here (http://www.youtube.com/user/ChiropracticNJ). Also check out our video on joint capsule stretches, since your's are likely very tight.
3. If the hips and legs do not feel right, consider other aerobic activities that day since running poorly will likely make you feel worse.

I hope that helps. Since a Mortons Toe is developmental, it is likely not something that created the problem but you can have it helped with an orthotic that has a mortons toe extension built into it (just a thought)